Pain scores at the insertion of the 52 MG levonorgestrel-releasing intrauterine system among nulligravidas and parous women

Chaves, Isabella A.; Baêta, Thaís; Dolabella, Gabriella B.; Barbosa, Luma R.; Almeida, Natália Maria de Castro; Oliveira, Flávio Roberto Azevedo de; Oliveira, Elaine Cristina Fontes de; Silva-Filho, Agnaldo L.; Rocha, Ana Luiza Lunardi

doi:10.1080/13625187.2021.1925882

Cited by 11 publications

(4 citation statements)

References 22 publications

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“…Chaves et al (2021) found that when compared to nulligravidas and women who had an elective caesarean delivery without any previous labour, women who had a previous vaginal delivery had lower pain levels at the time of levonorgestrel IUD placement 25 . In our study, we found that women with a history of previous elective cesarean-delivery who received vaginal misoprostol experienced a less painful levonorgestrel IUD insertion.…”

Section: Discussionmentioning

confidence: 99%

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Salama

Eltemamy

Abdel-Rasheed

et al. 2022

Al-Azhar International Medical Journal

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Section: Discussionmentioning

confidence: 99%

Role of vaginal misoprostol prior to levonorgestrel-releasing IUD insertion

Salama

Eltemamy

Abdel-Rasheed

et al. 2022

Al-Azhar International Medical Journal

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“…Of the included studies, four of them explored how different patient circumstances influenced pain scores regarding IUD insertions [7,[21][22][23]. Among these studies, some explored the involvement of psychosocial factors in anticipated pain [7,21], while others examined the different experiences of nulligravidas and parous women during the procedure [22,23].…”

Section: Circumstantial Factorsmentioning

confidence: 99%

“…Similarly, the final study under circumstantial factors explored how gynecological history impacts pain scores [ 23 ]. Multiple linear regression analysis demonstrated that 29.5% of the variability in the pain score was explained by nulligravid or women who had elective cesareans and difficulty at IUD insertion.…”

Section: Reviewmentioning

confidence: 99%

“…Nulligravid women presented a higher mean pain score of 6.6 ± 2.0 when compared to women with elective cesarean delivery, 5.5 ± 2.1, and women with previous vaginal delivery, 3.9 ± 2.4 (p < 0.001). These two groups with high pain scores (nulligravid and cesareans) were also more likely to have pain classified as moderate or severe (in relation to absent or mild) than women with previous vaginal delivery (p < 0.001) [ 23 ].…”

Section: Reviewmentioning

confidence: 99%

See 1 more Smart Citation

Differing Approaches to Pain Management for Intrauterine Device Insertion and Maintenance: A Scoping Review

Rahman,

King,

Saikaly

et al. 2024

Cureus

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Intrauterine devices (IUDs) are considered a reliable contraceptive option for women, but they can come with side effects. There is a disconnect in standard guidelines for IUD insertion within and without the U.S. The objective of this review was to address a gap in the literature regarding official procedures for pain management during IUD implantation. This scoping review was initiated using keywords to extract relevant articles from multiple databases: U.S. National Library of Medicine National Institutes of Health (PubMed), MEDLINE (Ovid), and Excerpta Medica dataBASE (EMBASE, Ovid). Initially, 457 articles were identified and after a rigorous screening and selection process, 37 articles were chosen to be further assessed to ascertain if they met the study's inclusion criteria. Those 37 articles were further evaluated fully to check for relevancy. From that process, 19 articles were chosen for the review, and all passed quality assessment evaluations using the JB Appraisal Tools. To best address the research question, the data from the 19 articles were divided into three categories: 1) circumstantial factors, 2) non-pharmacological methods, and 3) pharmacological methods. Circumstantially, women with previous vaginal deliveries experienced the lowest pain during the procedure, and nulligravid (never pregnant) women experienced the most pain. Lower pain scores were reported by lactating women compared to non-lactating. Black women experienced the most anticipated pain compared to other races. Regarding non-pharmacological methods, different insertion techniques, tools, and the use of a cold compress were found to not affect the level of pain during IUD insertion. Lastly, it was shown that pharmacological methods such as lidocaine gel, lidocaine paracervical block, and lidocaine combined with either diclofenac or prilocaine decreased pain scores at different time stamps of the procedure. Also, oral ketorolac and a vaginal combination of misoprostol and dinoprostone helped reduce pain. Findings from this scoping review revealed a lack of uniformity across practices when performing IUD insertions, possibly due to differences in procedures across circumstantial factors, nonpharmacological methods, and pharmacological methods. More research is needed to investigate the intricacies of pain with IUD insertion. Moving forward, especially following a potential increase in the use of IUDs after the reversal of Roe v. Wade, establishing this gap may lead to a more refined standardized protocol to mitigate pain with IUD insertions.

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